Foundations in Personalized Health Care: Personalizing the Perfect Workout

Robin Marcus presented the potential benefits of personalized fitness and nutrition interventions as part of the CCTS-supported Foundations in Personalized Health Care course, which was designed to introduce students to many facets of this emerging field.

Robin Marcus, PhD, associate professor of physical therapy, began her lecture by quoting Hippocrates (460-377 BC) — if we could give every individual the right amount of nourishment and exercise, not too little and not too much, we could have found the safest way to health. Unfortunately, the medical community is realizing that fitness is more complicated than the simplified approach put forth by the father of modern medicine.

Chronic diseases, such as heart disease, stroke, diabetes, are on the rise, and only 5 percent of American adults get the recommended 150 minutes of physical activity a week. “Almost three-quarters of every dollar spent on health care is the result of a disease that could have been prevented by different lifestyle choices,” said Marcus.

Contrary to the traditional approach to health, there is no one-size fits all program and no magic pills. Not everyone responds in the same way to the same stimulus, explained Marcus. To illustrate this point, she pointed to the international multi-university Heritage family study (HEalth, RIsk factors, exercise Training And GEnetics), which examined the role of genetics in cardiovascular, metabolic, and hormonal responses to exercise. The study showed markedly different response of individuals to an intervention. In addition, diet and physical activity may affect how genes are regulated.

Genetic factors might even influence how a person responds to exercise. “Some people hate exercise,” said Marcus. “It is not that people are lazy, but genetics may influence the way you feel during exercise.”

Marcus suggests approaching health through personalized medicine. “Health is a multi-faceted endeavor that should focus on changing a person’s lifestyle, whether that be through exercise, nutrition, or lifestyle choices,” she said. Personalized medicine offers clinicians the opportunity to change the conversation and find new, customized health interventions, especially for people who have chronic diseases.

Making treatment more personalized means looking beyond the group mean to identify the sources of variability in how different people respond to exercise, fitness, and nutrition. Marcus suggested a nested approach, which identifies people as responders or non-responders to a particular intervention.  “You can try different interventions that might be more effective for the non-responder group and revise dosing recommendations for the responder group,” she said.

We may be closer to personalized fitness interventions than you may think. Wearable devices and fitness apps empower consumers to manage their health, driving a health revolution. “These devices are overtaking the data collected by clinicians,” she said. She proposes that clinicians leverage the real-time data collected by an individual to develop personalized fitness interventions.

So, what might the future of personalized fitness look like?

Marcus envisions a future where consumers can input their personalized fitness data into electronic medical records. Clinicians could use this information in conjunction with genetic tests to understand a broad spectrum of the population. “At the moment, most genetics only looks at sick people,” said Marcus.  “This new, inclusive approach could provide the information needed to build a roadmap to learn how to help people stay healthy.”

It may take time to reach the proposed future. Until then, Marcus has a back-up plan. “We cannot forget to eat well and get up and move,” she said.